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As Seen in the Daily Mail: Dr Ross Perry Explains the 4 Types of Facial Ageing
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Dr Ross Perry Explains the Four Main Ways We Age
And What You Can Do About It
When it comes to facial ageing, there is no one-size-fits-all approach. Some people lose facial volume, others notice sagging skin, while many first become concerned about wrinkles caused by repeated facial expressions.
Recently featured in the Daily Mail, Dr Ross Perry, Founder and Medical Director of Cosmedics, shared his expert insight into the four common facial ageing patterns – helping people better understand why they age the way they do and which treatments can offer the most effective results.
Understanding your own ageing profile is often the first step towards choosing the right non-surgical treatment, whether that’s anti-wrinkle injections, dermal fillers or collagen-stimulating procedures.
Why do we all age differently?
As Dr Ross Perry explained in the Daily Mail:
“The idea that we’re all either a sinker, sagger, frowner or raiser has become increasingly popular because it offers a simple way of understanding the different ways our faces age.
It is a useful framework for explaining why some people are more prone to volume loss, others experience sagging, and some develop wrinkles in particular areas.”
While genetics undoubtedly play a role, lifestyle, sun exposure, facial anatomy and repeated muscle movement all influence how our faces change over time. Recognising your dominant ageing pattern allows treatments to be tailored to your individual concerns rather than taking a generic approach.
The Frowner
Frowners tend to develop lines between the eyebrows and around the upper face as a result of repeated facial expression.
Dr Perry explains:
“Frowners are characterised by the development of lines between the eyebrows, often referred to as frown lines or 11 lines.
These occur due to repeated muscle movement over time combined with the natural ageing process.
A good skincare routine can help maintain skin quality, but because these lines are largely driven by muscle activity, anti-wrinkle injections are often considered the most effective treatment for softening their appearance.
Retinoids, antioxidants and daily sun protection can also help support collagen levels and minimise the formation of deeper static lines.”
Many patients choose wrinkle-relaxing injections because they soften expression lines while maintaining natural facial movement when administered by experienced medical practitioners.
Discussing celebrity examples, Dr Perry commented:
“Brooke Shields is often cited as an example of a frowner. She has always been highly expressive, and that natural animation is part of what has made her so recognisable throughout her career.
In people with this type of facial movement, repeated muscle activity can contribute to the development of more noticeable frown lines over time, even when overall skin quality remains very good.
Tom Hanks is another example frequently associated with the frowner category. He is known for his expressive face and animated reactions, both on screen and in public appearances.
As we age, years of repeated facial movements naturally begin to leave their mark on the skin, particularly in the area between the eyebrows and across the upper face. This is a classic characteristic of the frowner ageing type.”
The Sinker
Some people don’t develop many wrinkles or sagging but instead notice their face becoming leaner and more hollow as natural fat pads diminish.
Dr Perry explains:
“The sinker types are people who tend to lose facial volume as they age.
The natural fat pads beneath the skin gradually diminish, particularly around the cheeks, temples and under-eye area, resulting in a more hollow or sculpted appearance.
For sinkers, skincare should focus on preserving collagen and supporting skin quality.
Daily SPF is essential, alongside ingredients such as retinoids, vitamin C and peptides.
Treatments that stimulate collagen production can also be beneficial, while carefully placed fillers or regenerative treatments may help restore lost support where appropriate.”
This ageing pattern often responds particularly well to carefully planned dermal fillers and regenerative aesthetic treatments that restore facial support without creating an overfilled appearance.
Dr Perry adds:
“Gillian Anderson is what would be described as a sinker, as although her facial structure has remained elegant and defined over the years, you can see a degree of natural volume loss through the mid-face that contributes to a more sculpted appearance.
Matthew McConaughey is another classic example of being a sinker. He has always had a lean facial structure, and as he’s aged, the natural reduction in facial volume has accentuated his cheekbones and jawline rather than leading to significant sagging.”
The Sagger
Saggers often retain facial fullness but notice softening around the jawline, cheeks and lower face as tissues gradually descend.
According to Dr Perry:
“Saggers tend to retain facial volume but experience more noticeable tissue descent over time.
As skin elasticity reduces and supporting structures weaken, the jawline may soften, and the lower face can appear heavier.
The priority for this ageing type is maintaining skin firmness and elasticity. Consistent use of SPF, retinoids and antioxidant-rich skincare can help support skin health.
In-clinic treatments such as radiofrequency and ultrasound-based skin-tightening procedures may be useful for some individuals, although more significant sagging can be difficult to address without surgery.”
For suitable patients, collagen-stimulating technologies can improve skin quality, while treatment plans may combine skin tightening with carefully placed injectables to create subtle rejuvenation.
Dr Perry explains:
“Lisa Kudrow largely maintained facial volume throughout her life. Rather than developing a hollow or gaunt appearance, the visible ageing changes are more associated with the natural downward movement of facial tissues, particularly in the mid and lower face, which is typical of the sagger category.
Johnny Depp is another example frequently associated with the sagger profile. Although facial ageing is influenced by many factors, he appears to have retained a reasonable degree of facial volume over time, with ageing changes being more evident through softening and downward movement of facial contours rather than hollowing.”
The Raiser
Raisers typically develop horizontal forehead lines caused by repeatedly lifting the eyebrows throughout life.
Dr Perry explains:
“Raisers tend to develop horizontal forehead lines caused by repeatedly lifting the eyebrows.
Over time, these expression lines can become more noticeable and may remain visible even when the face is at rest.
As with all ageing types, SPF remains the most important anti-ageing product. Retinoids, antioxidants and hydrating ingredients can help improve overall skin quality, while anti-wrinkle injections may be used to soften forehead lines and reduce the impact of repeated muscle movement.”
This type of ageing often responds very successfully to expertly administered anti-wrinkle injections, helping soften forehead lines while preserving natural expression.
Discussing well-known examples, Dr Perry says:
“Jennifer Aniston is frequently referenced when discussing raisers.
She has long been known for her expressive facial mannerisms, particularly through the eyes and forehead.
As is common with this ageing type, repeated brow elevation can gradually lead to more pronounced horizontal forehead lines becoming a defining feature of the ageing process.
George Clooney is also often cited as an example of a ‘raiser’. Throughout his career, he has maintained a highly expressive upper face, and the horizontal forehead lines that have developed over time are characteristic of individuals who rely heavily on eyebrow movement when communicating.
Despite this, he has retained strong facial structure and relatively little tissue descent, meaning forehead lines remain one of the more dominant signs of ageing.
Helen Mirren is another good example of the raiser category. Her facial expressions have always been animated and engaging, and this natural expressiveness is often reflected in the forehead.
Rather than significant volume loss or marked sagging, the ageing changes that stand out most are those associated with years of repeated upper-face movement.”
Read this article in full
Choosing the Right Anti-Ageing Treatment
Although these four ageing patterns provide a useful framework, most people display characteristics of more than one category. An experienced medical aesthetic practitioner will assess facial anatomy as a whole before recommending treatment.
At Cosmedics, every treatment plan is tailored to the individual, whether the goal is softening expression lines with anti-wrinkle injections, restoring lost volume using dermal fillers, improving skin quality through Profhilo or polynucleotides or laser/IPL treatment. The clinicians also see outstanding results through combining treatments for comprehensive facial rejuvenation.
As featured in the Daily Mail, Dr Ross Perry continues to champion a personalised, medically led approach to aesthetics—helping patients achieve fresher, natural-looking results that enhance rather than change their appearance.
Book a Consultation
If you’re beginning to notice signs of facial ageing, a consultation with Dr Ross Perry and the experienced Cosmedics medical team can help identify your individual ageing pattern and recommend the most appropriate non-surgical treatments to achieve refreshed, natural-looking results.
Dr Ross Perry
Dr Ross Perry regularly provides expert comment and advises the media on a range of skincare and health-related issues.
He has particular expertise in skin surgery mole removal and melanoma; having removed thousands of moles in his career, both within the NHS and privately through Cosmedics Skin Clinics. He has provided expert advice on sun damage and sun protection for a variety of UK media and publications.
He also comments on the latest cosmetic and anti-ageing treatment methods.
Cosmedics Skin Clinics
Cosmedics Skin Clinics was established in 2003 and has built up an excellent reputation for cosmetic and medical skin treatments, carried out by GMC Registered Doctors. The company offer a full range of cosmetic treatments, including popular lip enhancement and wrinkle relaxing injections, dermal fillers; plus medical treatments including mole removal, thread vein treatment and excessive sweating injections.
Cosmedics Skin Clinics has a team of skin treatment doctors and surgeons in their skin clinics across London and Bristol led by Dr Ross Perry.
Call 020 7386 0464 or email [email protected] to book an appointment.
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